ASH endorses RCP call for a tobacco harm reduction strategy.

3 October 2007

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Wednesday 03 October 2007

ASH is today calling on the Government to develop a harm reduction strategy for tobacco.

ASH endorses the key findings of a report published today by the Royal College of Physicians. [1] The report notes that despite a steady decline in overall smoking rates, the most disadvantaged smokers, who tend to be the most heavily addicted to nicotine, are still not quitting.

The report notes that whilst it is the nicotine in tobacco that keeps people hooked, the harm from smoking is caused primarily by the thousands of poisons in tobacco smoke. Medicinal nicotine, on the other hand, is relatively safe but little has been done to promote longer term use of nicotine replacement therapy (NRT) as an alternative to smoking for those who can’t quit. [2]

The Medicines and Healthcare Products Regulatory Agency (MHRA) has taken steps to increase the accessibility of NRT but much more needs to be done. [3] ASH believes that a review of the whole nicotine and tobacco market is needed in order to allow safer nicotine products to be made available whilst ever stricter measures are applied to tobacco products to deter their use.

Deborah Arnott, Director of the health campaigning charity ASH, said:

“This Government has done more than any previous UK government to tackle the tobacco epidemic. However, smoking rates are still only declining by 0.4% per year with the most disadvantaged in society finding it hardest to quit. Additional measures are needed to reduce the terrible toll of illnesses and premature death caused by smoking. It is up to the Government to take the lead and to help those people who are unable to quit smoking.”

While the setting up of a tobacco regulatory authority would take some time to achieve, there are interim steps that could be taken. Specifically, ASH calls on the Government to:

• Sponsor educational campaigns to raise awareness of the relative safety of medicinal nicotine products compared to cigarettes. [4]
• Maintain the VAT reduction on nicotine replacement therapies that was introduced on 1 July 2007
• Work with the MHRA to improve regulation of medicinal nicotine to encourage longer term use among most heavily addicted smokers who are currently unable to quit.

In addition ASH calls on the pharmaceutical industry to develop new, cheaper NRT products that will be attractive to long-term heavy smokers unable to quit as a viable alternative to cigarettes.

Notes and links:
[1] Harm Reduction in Nicotine Addiction: Helping people who can’t quit. RCP, London.
[2] For many years the annual Smoking Attitudes and Behaviour survey has shown that around 70% of smokers report that they want to quit smoking, yet fewer than 5% per year manage to do so. In the 2006 survey 78% of current smokers reported having tried to quit at some time in the past.
[3] The MHRA has licensed NRT to be used up to 9 months, and for smokers with coronary heart disease, pregnant smokers and young smokers. The MHRA has also licensed NRT for cutting down whilst smoking and for temporary abstinence.
[4] Currently most smokers don’t understand that it is the smoke and not the nicotine that harms them. Unpublished data from smokers in October 2002 found that 57% of smokers believed that it was the nicotine that caused most of the cancer from smoking and similar numbers believe nicotine causes heart disease and asthma. A third of smokers thought that stop smoking products with nicotine are just as harmful as smoking As a result many do not even use the existing nicotine replacement products to help them give up smoking, and if they do, don’t use them for sufficient time for them to be fully effective.
A survey by the British Heart Foundation found that more than half of Britain’s 12 million smokers wrongly believe nicotine and not tobacco smoke is what causes heart disease. BHF, Oct 2005. http://news.bbc.co.uk/1/hi/health/4363346.stm
[5] The call for a review of nicotine regulation was also endorsed by the UK National Conference on Smoking Cessation in June. The conference concluded that it “supports the RCP call for an overhaul of nicotine regulation to give smokers long term access to less harmful forms of nicotine as real alternatives to smoking.”
[6] ASH was founded in 1971 by the Royal College of Physicians. ASH continues to work closely with the RCP via its Tobacco Advisory Group. ASH’s Director, Deborah Arnott is a member of the Working Group and contributed to two of the College’s recent reports: “Going smoke-free. The medical case for clean air in the home, at work and in public places” and the current report on harm reduction.
[7] ASH is funded by Cancer Research UK, the British Heart Foundation and the Department of Health. ASH does not receive any funding from the pharmaceutical industry.

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